Posts Tagged With: opioid

***The Deception: Tylenol, Opioids and the DEA***; Alex DeLuca; [Addiction, Pain and Public Health website][app]; Date. [*Source*][source] —- We are in the midst of a fascinating media firestorm, an ejaculation of drug war Trash Journalism brought about by a veritable perfect storm of events including: The rediscovery by the FDA that acetaminophen (Tylenol) and NSAID (aspirin, ibuprophen, naprosyn, Vioxx, etc) toxicity are serious public health problems; A focus on “Vicodin” and “Percoset” as representatives of the class of low-potency opioid formulations which include Tylenol, and widespread calls for [banning these …

The treatment of chronic pain is an issue of national importance. If petitioner’s conviction is allowed to stand then any single opioid prescription can be called into question based upon misconceptions which should not be allowed to permeate the atmosphere of The American Courtroom.

Maybe we all deserve the pain. If we are too stupid to understand that aspirin kills way more people than morphine, and that there are a whole lot worse things for you and your damn Federal prosecutors to worry about than if maybe your neighbor is getting too much pain relief (sheesh!) – if you are that effin stupid then maybe you deserve the chronic pain which YOUR government has already imposed on you and your children as the defacto law of the land.

Wow. To win acquittal on federal drug trafficking charges is very difficult and very rare, as I have [discussed before][rm]. A resounding win is almost unheard of. I will be very interested in the outcome of the prosecutorial misconduct case being brought by Dr. Shaygan’s defense attorney, Mr. Markus.

Excerpt: “Dr. Mangino has been unjustly prosecuted and convicted in Pennsylvania. His case is unusual. He is currently incarcerated at SCI-Cresson… Essentially, in PA and nationwide, if this conviction is allowed to stand on the grounds presented by prosecution, then any single opioid prescription can be deemed illegal.” — Dr. Mangino

In pain medicine we have the deeply disturbing situation that what most doctors do (medical community norm) is at odds with, and clearly below, the medical standard of care. Literally, in the treatment of chronic pain, an ethical physician attempting to practice in good faith, according to the clinical literature, is an outlier deviating from how most reputable physicians would practice.

Take a moment to scan one or two of these Highly Recommended documents… good background reading for any serious student of the war on docs and the pain crisis. A Critical Assessment of the Impact of Drug Testing Programs on the American Workplace is a good review of this important related drug war topic that is currently in the news (govt push to drug test high school students);
War on Drugs, War on Doctors, and the Pain Crisis in America — this is probably THE CORE document; if you only …

Many physicians are concerned that prescribing opioid analgesics in chronic pain treatment is accompanied by an unacceptable risk of unwarranted prosecution. The validity of this fear is evaluated by examining the standards through which physicians are targeted and prosecuted. Prohibition law is identified as an error in social policy that distorts medical standards.

I am very glad to see physicians, who have themselves been savaged by the government, publishing their stories. Consider Dr. Jackson’s article, Conviction without a Crime, to be a companion piece to Dr. Rottschaefer’s article discussed in the previous item here, The Criminal Criminal Justice System. Together these two articles will give the reader a good sense, I think, of the utter breakdown of professional ethics, common sense, and fairness in any case involving controlled substances.

Unrelieved pain has a devastating impact on the physical, emotional, social, and economic well being of patients and their families. Diagnosing and treating pain is, therefore, fundamental to the public health. Terminology is review, myths identified, and medical understanding is stated.

I spoke to Billy’s wife briefly, recently, and am very happy to be able to report that Dr. Hurwitz is no longer in federal prison. He is currently in a half-way house in D.C. and will be transitioning to house arrest as part of his parole and probation requirements… He is in a sort of “titration to house arrest” best I understand it. Meaning, he is starting to get overnight visits with his family – YEA! – and more and more of that till he sort of “stabilizes” on a regimen of maintenance house arrest. (Is house arrest a substitution therapy for …

Update on the case of USA v Dr. Martinez in Washington state. Martinez has been acquitted of all drug crime charges. The fraud charges remaining after her 2007 fed trial have also been dismissed, but the govt can bring the fraud charges anew. Also examined is a recent Yakima Herald article announcing “new” charges that are not, in any reality-based sense, “new” at all.

Abstract of peer-reviewed article reporting multicenter outcomes for safety and analgesic efficacy of high-dose, transdermal buprenorphine in the treatment of chronic pain, and brief comments on same by Dr. Alex DeLuca, and with links to related discussions on the Pallimed blog.

The article well describes the public health chaos this is the predictable consequence of clinical and public health authorities abandoning their real mission to uphold the medical standard of care for their citizenry, and instead focusing exclusively on the policeman’s agenda which prioritizes ‘catching a few addicts’ over providing adequate pain management for legions of innocent patients.

It seems to me an uncivilized and insane notion that just because someone in current moderate to severe pain had a history of an alcohol or drug problem, or even a current substance abuse problem, that you would deny them opioid therapy if that was the best medication to relieve their suffering. But this seems to be a point of confusion that increasingly comes up from patients, doctors, and regulators alike. So, in this post, let me make the medical standard of care in this situation perfectly clear. [...]

Excerpt: “As usual, the academics ignore the elephant in the living room. Regarding review articles that wring their hands about the lack of long term evidence of the safety and efficacy of opioid analgesic therapy, they never discuss the impossibility of measuring the efficacy and safety of a therapy that almost no physician is comfortable doing properly. For an excellent analysis of what we might call the “new academic opiophobia,” see the Pain Relief Network’s 2008 “WA State Tort Claim” pages 34 – 37.”

***Pain Relief Network files State Tort Claim vs. WA State***; Laura Cooper, Esq.; [Pain Relief Network][prn]; 2008/07/08. [**Full text PDF**] **Permalink:** http://doctordeluca.com/wordpress/archive/prn-tort-claim-vs-wa/ **See also:** [**PRN Complaint for Declaratory and Injunctive Relief, and Damages**][d1] – 2008 and, [**WA's Interagency Guideline on Opioid Dosing for Non-Cancer Pain**][d2] – 2007 —- SUMMARY: Nature of Relief Sought: This lawsuit is the result of grossly misinformed prejudices about opioid(1) pain medications held by high-level Washington public health officials. Those prejudices are identified in medical literature …

The nonprofit Pain Relief Network (PRN) says the guidelines for prescribing narcotics, written by the Washington state Department of Health and published in March 2007, have influenced pain treatment across the country and have made doctors afraid to give opiate prescriptions. Siobhan Reynolds, PRN president, says the group decided to target WA because the state has been a leader both in pain treatment and in restricting doctors’ prescriptions of pain relief medication. [...]

Other People Get It – a War on Doctors/Pain Crisis YouTube Playlist. Seven drug war/pain crisis related videos, not directly Pain Relief Network related, that I like or think are otherwise worthwhile.

Excellent article by Dr. Forest Tennant explaining and demystifying chronic opioid therapy for chronic pain.